Medical cannabis in fibromyalgia: a cohort study for a promising alternative

Authors

DOI:

https://doi.org/10.34024/rnc.2023.v31.14897

Keywords:

Fibromyalgia, Cannabis, Cannabinoids, Chronic pain

Abstract

Introduction. Fibromyalgia is characterized by generalized musculoskeletal pain, sleep disturbances, fatigue, headache, and cognitive symptoms. The endocannabinoid system seems to play an important role in the pathophysiology of this disease and the use of phytocannabinoids is presented as a possible therapeutic option. Objective. To evaluate the effects of the use of herbal cannabinoids, orally and topically, on specific symptoms of fibromyalgia, in addition to evaluating the safety and adverse effects of the treatment. Method. This is an observational, prospective cohort study. The outcome of the use, orally and topically, of oil and ointment derived from the Cannabis sp plant in the most frequent symptoms of fibromyalgia was evaluated. Results. Ten medical records were analyzed and 100% of the patients were female. After the start of treatment, it was possible to observe an improvement in anxiety and insomnia, with a significant difference, as well as a tendency to improve depressive symptoms. There was also a decrease in the use of non-steroidal anti-inflammatory analgesics, a decrease in FIQ and pain scale scores, and a trend towards a decrease in the use of opioids. Mild adverse effects were reported by 71.4% of participants and had complete resolution within the first month of treatment. Conclusion. Despite the need for further studies, treatment with medical cannabis was shown to be effective and safe for patients with fibromyalgia.

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References

Ablin JN, Cohen H, Buskila D. Mechanisms of Disease: genetics of fibromyalgia. Nat Clin Pract Rheumatol 2006;2:671-8. https://doi.org/10.1038/ncprheum0349

Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci 2018;19:1-23. https://doi.org/10.3390/ijms19030833

Morales P, Hernandez-Folgado L, Goya P, Jagerovic N. Cannabinoid receptor 2 (CB2) agonists and antagonists: a patent update. Expert Opin Ther Pat 2016;26:843-56. https://doi.org/10.1080/13543776.2016.1193157

Mechoulam R, Parker LA. The endocannabinoid system and the brain. Annu Rev Psychol 2013;64:21-47. https://doi.org/10.1146/annurev-psych-113011-143739

Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, et al. Isolation and Structure of a Brain Constituent That Binds to the Cannabinoid Receptor. Science 1992;258:1946-9. https://doi.org/10.1126/science.1470919

Santos RG, Hallak JEC, Crippa JAS. Neuropharmacological Effects of the Main Phytocannabinoids: A Narrative Review. Adv Exp Med Biol 2021;1264:29-45. https://doi.org/10.1007/978-3-030-57369-0_3

Almeida DL, Devi LA. Diversity of molecular targets and signaling pathways for CBD. Pharmacol Res Perspect 2020;8:1-10. https://doi.org/10.1002/prp2.682

Chaves C, Bittencourt PCT, Pelegrini A. Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Pain Med 2020;21:2212-9. https://doi.org/10.1093/pm/pnaa303

Boehnke KF, Gagnier JJ, Matallana L, Wiliiams DA. Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey. J Pain 2021;22:556-66. https://doi.org/10.1016/j.jpain.2020.12.001

Rana T, Behl T, Sehgal A, Mehta V, Singh S, Kumar R, et al. Integrating Endocannabinoid Signalling In Depression. J Mol Neurosci 2021;71:2022-34. https://doi.org/10.1007/s12031-020-01774-7

Habib G, Artul S. Medical Cannabis for the Treatment of Fibromyalgia. J Clin Rheumato 2018;24:255-8. https://doi.org/10.1097/RHU.0000000000000702

Habib G, Avisar I. The Consumption of Cannabis by Fibromyalgia Patients in Israel. Pain Res Treant 2018;2018:7829427. https://doi.org/10.1155/2018/7829427

Turna J, Simpson W, Patterson B, Lucas P, van Ameringen M. Cannabis use behaviors and prevalence of anxiety and depressive symptoms in a cohort of Canadian medicinal cannabis users. J Psychiatr Res 2019;111:134-9. https://doi.org/10.1016/j.jpsychires.2019.01.024

Murillo-Rodríguez E. The role of the CB1 receptor in the regulation of sleep. Prog. Neuropsychopharmacol. Biol Psychiatry 2008;32:1420-7. https://doi.org/10.1016/j.pnpbp.2008.04.008

Murillo-Rodríguez E, Millán-Aldaco D, Di Marzo V, Drucker-Colín R. The anandamide membrane transporter inhibitor, VDM-11, modulates sleep and c-Fos expression in the rat brain. J. Neuroscience 2008;11:1-11. https://doi.org/10.1016/j.neuroscience.2008.08.056

Wickwire EM, Tom SE, Scharf SM, Vadlamani A, Bulatao IG, Albrecht JS. Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries. Sleep 2019;42:1-8. https://doi.org/10.1093/sleep/zsz007

Murillo-Rodríguez E, Machado S, Rocha NB, Budde H, Yuan TF, Arias-Carión O. Revealing the role of the endocannabinoid system modulators, SR141716A, URB597 and VDM-11, in sleep homeostasis. Neuroscience 2016;339:433-49. https://doi.org/10.1016/j.neuroscience.2016.10.011

Painter JT. Chronic Opioid Use in Fibromyalgia Syndrome A Clinical Review. J Clin Rheumatol 2013;19:72-7. https://doi.org/10.1097/RHU.0b013e3182863447

Santos INC, Escobar OS, Rodrigues JLG. Revisão Bibliográfica do Uso Indiscriminado dos Anti-Inflamatórios Não Esteroidais (AINES). REASE 2021;7:330-42. https://doi.org/10.51891/rease.v7i5.1197

Wang SC, Chen YC, Lee CH, Cheng CM. Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. Int J Mol 2019;20:1-17. https://doi.org/10.3390/ijms20174294

Nielsen S, Sabioni P, Trigo JM, Ware MA, Betz-Stablein BD, Murnion B, et al. Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis. Neuropsychopharmacology 2017;42:1752-65. https://doi.org/10.1038/npp.2017.51

Wolf J, Urits I, Orhuru V, Peck J, Orhurhu MS, Giacomazzi S, et al. The Role of the Cannabinoid System in Pain Control: Basic and Clinical Implications. Curr Pain Headache Rep 2020;24:1-11. https://doi.org/10.1007/s11916-020-00873-9

McDonagh MS, Morasco BJ. Cannabis-Based Products for Chronic Pain. Ann Intern Med 2022;175:1143-53. https://doi.org/10.7326/M21-4520

Bergeria CL, Strickland JC, Spindle TR, Kalaba M, Satyavolu PU, Feldner M, et al. A crowdsourcing survey study on the subjective effects of delta-8-tetrahydrocannabinol relative to delta-9-tetrahydrocannabinol and cannabidiol. Exp Clin Psychopharmacol 2022;31:312-7. https://doi.org/10.1037/pha0000565

Ruiz-Montero P, Segura-Jimenez V, Álvarez-Gallardo IC, Nijs J, Mannerkorpi K, Delgado-Fernandez M, et al. Fibromyalgia Impact Score in Women with Fibromyalgia Across Southern, Central, and Northern Areas of Europe. Pain Physician 2019;22:511-6. https://doi.org/10.36076/ppj/2019.22.e511

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Published

2023-08-16

How to Cite

Mendes da Silva, L., Ribeiro de Novais Júnior, L., Meneguzzo, V., Vicente da Silva, T., Rodrigues da Rosa, L., de Souza, T. O., & Mariano Bitencourt, R. (2023). Medical cannabis in fibromyalgia: a cohort study for a promising alternative. Revista Neurociências, 31, 1–17. https://doi.org/10.34024/rnc.2023.v31.14897

Issue

Vol. 31 (2023)

Section

Artigos Originais

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Copyright (c) 2023 Larissa Mendes da Silva, Linério Ribeiro de Novais Júnior, Vicente Meneguzzo, Tiago Vicente da Silva, Lara Rodrigues da Rosa, Tiago Odílio de Souza, Rafael Mariano Bitencourt

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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